Dr Hugo Kitchen of Stratford Dermatherapy Clinic Warwickshire sorts the myths from the facts about the UK’s number one non-surgical treatment… Botox
“It’s a poison”
Botulinum toxin is a poison. But so is pretty much anything if you inject too much of it into you – to actually fatally poison someone with botulinum toxin (Botox) you would have to inject between 50 and 100 vials of the stuff intravenously. There isn’t room in my fridge for that much toxin.
“It’s going to be painful”
Everyone is different with different pain thresholds, but this is a very quick procedure and should not be painful if you see an experienced practitioner. From the first Botox injection to the last it should take about two to three minutes.
“There’s only one option on the market – Botox”
Botox itself is not actually licensed for cosmetic use; it is Vistabel that can be used in cosmetic treatments. There are two companies offering botulinum toxin type A products that have a license for use in facial cosmetic procedures and they are both reputable with good safety profiles.
I prefer to offer my patients Azzalure from Galderma because it is a great product that takes effect very quickly but I also think Galderma looks after its doctors by educating them and is working hard to standardise treatment techniques, which is very desirable.
“I’m worried it will migrate around my body”
It doesn’t float around the body – it enters the nerve endings within ten seconds. Then it takes between 24 hours and two weeks – depending on which product you’re injecting – to switch off the neurosynaptic muscle information system so the muscles relax.
“It can lead to permanent paralysis”
Patients often can’t imagine after their first treatment that it will ever wear off, as it is so effective, but it does. The nerve endings start to sprout again and reattach themselves to the muscle.
We have been using botulinum toxin in amounts that are 100 times greater than that which is injected into your face to treat patients suffering from muscle spasms over the past fifty years. We know what the long-term effects of this product are and there aren’t any – we have a huge safety profile to fall back on.
‘Botox’ has got bad press because there are famous faces getting too much of it and there are practitioners who aren’t properly trained injecting it.
“I’ve heard it can cause droopy eyelids”
This should not occur because it should be obvious at the consultation stage if a patient is suitable for this treatment. There are some people who have too much loose skin on their forehead and you just don’t give them botulinum toxin – their forehead will drop down like an old pair of trousers!
At the consultation you have to test for skin laxity both on the forehead and in the upper and lower lid area by doing the snap test; you pinch the skin and let it go and see how quickly it reverts back into place. “I will end up looking frozen”
It is perfectly possible to have botulinum toxin without totally immobilising the face. Movement and a few lines around the eyes looks sexy and feminine. Generally speaking, that frozen look is caused by too much toxin in the wrong places and that shouldn’t happen anymore thanks to the work done by manufacturers such as Galderma.
Although not the law in the UK, in France and other countries in Europe each vial should be single use and then you dispose of it. Galderma only produce vials that have single use so there is no margin for error. The syringes Galderma produce are marked on one side with the exact quantities that you need to dilute the product and on the other side the syringe is marked with exactly the right amount that you’re supposed to inject in each area.
Galderma also established a botulinum toxin working group to do anatomical studies to guide practitioners in the use of this drug; exactly where and how deep to inject it and what dosage. They believe in educating their doctors and I have certainly benefited from the training they offer.
I have been running my clinic for 21 years and I was happy with the results I achieved before but now I think I’m getting even better results with Azzalure. A doctor would have to be very arrogant not to take advantage of the training and the opportunity to improve.
“It can have a cumulative effect”
This toxin has been around for fifty years and we know it has no cumulative effect. However, it can have some long-term effects.
When we see a patient for the first time it is like the muscles that cause dynamic wrinkles have been trained in the gym – they are strong because they have been in daily use. Once the botulinum toxin has dissipated then the muscles will revert back to how they were before but with repeated treatments then you do start to see these muscles become retrained as they are not in constant use – it is the same effect that you would get in other muscles if you stopped going to the gym. Over time they would become less bulky and weaker.
So the time between treatments can get longer but that is fine with me – yes, it means less money but I’m happy about that because it gives me a good reputation with my patients.
To book a botox consultation at Dr Hugo Kitchen’s clinic in Stratford Upon Avon in Warwickshire please complete the form on this page